High in-vivo accuracy of a novel robotic-arm-assisted system for total knee arthroplasty.

IF 3.3 2区 医学 Q1 ORTHOPEDICS Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-01-01 Epub Date: 2024-05-20 DOI:10.1002/ksa.12272
Faseeh Zaidi, Craig M Goplen, Connor Fitz-Gerald, Scott M Bolam, Michael Hanlon, Jacob T Munro, Andrew P Monk
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引用次数: 0

Abstract

Purpose: Robotic-assisted total knee arthroplasty (TKA) has been shown to improve the accuracy and precision of bony resections and implant position. However, the in vivo accuracy of the full surgical workflow has not been widely reported. The primary objective of this study is to determine the accuracy and precision of a robotic-arm-assisted system throughout the intraoperative workflow.

Methods: This was a retrospective cohort study of adult patients who underwent primary TKA with various workflows and alignment targets by three arthroplasty-trained surgeons with previous experience using the ROSA® Knee System (Zimmer Biomet) over a 3-month follow-up period. Accuracy and precision were determined by measuring the difference between various workflow time points, including the final preoperative plan (PP), robot-validated (RV) resection angle and postoperative radiographs (PR). The absolute mean difference between the measurements determined accuracy, and the standard deviation represented precision. The lateral distal femoral angle, medial proximal tibial angle, femoral flexion angle and tibial slope were measured on postoperative coronal long-leg radiographs and true short-leg lateral radiographs.

Results: A total of 77 patients were included in the final analyses. The accuracy for the coronal femoral angle was 1.62 ± 1.11°, 0.75 ± 0.79° and 1.96 ± 1.29° for the differences between PP and PR, PP and RV and RV and PR. The tibial coronal accuracy was 1.44 ± 1.03°, 0.81 ± 0.67° and 1.57 ± 1.14° for PP/PR, PP/RV and RV/PR, respectively. Femoral flexion accuracy was 1.39 ± 1.05°, 0.83 ± 0.59° and 1.81 ± 1.21° for PP/PR, PP/RV and RV/PR, respectively. Tibial slope accuracy was 0.99 ± 0.72°, 1.19 ± 0.87° and 1.63 ± 1.11°, respectively. The proportion of patients within 3° was 93.2%, 95.3%, 97.3% and 94.6% for the distal femur, proximal tibia, femoral flexion and tibial slope angles when the final intraoperative plan was compared to PRs. No patients had a postoperative complication at the final follow-up.

Conclusions: The ROSA Knee System has acceptable accuracy and precision of coronal and sagittal plane resections with few outliers at various steps throughout the platform's entire workflow in vivo.

Level of evidence: Level III.

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用于全膝关节置换术的新型机械臂辅助系统具有极高的体内精确度。
目的:机器人辅助全膝关节置换术(TKA)已被证明可提高骨切除和植入物位置的准确性和精确度。然而,完整手术工作流程的活体精确度尚未得到广泛报道。本研究的主要目的是确定机器人手臂辅助系统在整个术中工作流程中的准确性和精确度:这是一项回顾性队列研究,研究对象是接受初级 TKA 手术的成年患者,他们在 3 个月的随访期内接受了由三位接受过关节置换术培训并具有使用 ROSA® 膝关节系统 (Zimmer Biomet) 经验的外科医生采用不同工作流程和对齐目标的手术。准确度和精确度是通过测量不同工作流程时间点之间的差异来确定的,包括最终术前计划 (PP)、机器人验证 (RV) 切除角度和术后 X 光片 (PR)。测量值之间的绝对平均差决定了准确度,标准偏差代表了精确度。股骨远端外侧角、胫骨近端内侧角、股骨屈曲角和胫骨斜度是通过术后长腿冠状位X光片和真实短腿侧位X光片测量的:结果:共有77名患者被纳入最终分析。股骨冠状角的准确度为 1.62 ± 1.11°,PP 和 PR、PP 和 RV 以及 RV 和 PR 之间的准确度分别为 0.75 ± 0.79°和 1.96 ± 1.29°。PP/PR、PP/RV和RV/PR的胫骨冠状位准确度分别为1.44 ± 1.03°、0.81 ± 0.67°和1.57 ± 1.14°。PP/PR、PP/RV 和 RV/PR 的股骨屈曲准确度分别为 1.39 ± 1.05°、0.83 ± 0.59°和 1.81 ± 1.21°。胫骨斜度准确度分别为 0.99 ± 0.72°、1.19 ± 0.87°和 1.63 ± 1.11°。术中最终方案与PR相比,股骨远端、胫骨近端、股骨屈曲和胫骨斜角在3°以内的患者比例分别为93.2%、95.3%、97.3%和94.6%。在最后的随访中,没有患者出现术后并发症:ROSA膝关节系统在冠状面和矢状面切除方面的准确性和精确度均可接受,在该平台的整个活体工作流程中,各步骤的异常值很少:证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.10
自引率
18.40%
发文量
418
审稿时长
2 months
期刊介绍: Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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